Individual provider · NPI-1

Andrii Terentyev, CMT, CST, MT

Massage Therapist · Indio, CA

NPI number1508633488
StatusActive
Last updated in NPPESDec 11, 2023

Details

NPI
1508633488
Entity type
Individual (NPI-1)
Name
Mr. Andrii Terentyev
Credential
CMT, CST, MT
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 11, 2023
Certification date
Jul 28, 2023
Last updated
Dec 11, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage Therapist95196CAYes

Practice location

82165 Doctor Carreon Blvd Apt 3d1
Indio, CA 92201-5878

Phone 213-401-5905

Mailing address

82165 Doctor Carreon Blvd Apt 3d1
Indio, CA 92201-5878

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